Neural substrates of the emotion-word and emotional counting Stroop tasks in healthy and clinical populations: A meta-analysis of functional brain imaging studies

The emotional Stroop task (EST) is among the most influential paradigms used to probe attention-related or cognitive control-related emotional processing in healthy subjects and clinical populations. The neuropsychological mechanism underlying the emotional Stroop effect has attracted extensive and long-lasting attention in both cognitive and clinical psychology and neuroscience; however, a precise characterization of the neural substrates underlying the EST in healthy and clinical populations remains elusive. Here, we implemented a coordinate-based meta-analysis covering functional imaging studies that employed the emotion-word or emotional counting Stroop paradigms to determine the underlying neural networks in healthy subjects and the trans-diagnostic alterations across clinical populations. Forty-six publications were identified that reported relevant contrasts (negative > neutral; positive > neutral) for healthy or clinical populations as well as for hyper- or hypo-activation of patients compared to controls. We demonstrate consistent involvement of the vlPFC and dmPFC in healthy subjects and consistent involvement of the vlPFC in patients. We further identify a trans-diagnostic pattern of hyper-activation in the prefrontal and parietal regions. These findings underscore the critical roles of cognitive control processes in the EST and implicate trans-diagnostic cognitive control deficits. Unlike the current models that emphasize the roles of the amygdala and rACC, our findings implicate novel mechanisms underlying the EST for both healthy and clinical populations.